# Rant - New Patient Waitlist at Doc's Office



## DreamWarrior (Jun 20, 2011)

So, I am looking for a new dermatologist and I have to pick one in my "network" of doctors if I want the insurance company to help pay for my visit...

The top doctors in my area happen to accept my insurance plan, but they're not available.

Here's how the conversation went:

Me: "Hi, I'd like to make an appointment with Dr. So-So."

Receptionist:  "Are you a new patient?"

"Yes"

"Okay, the first available appointment for new patients is August 12th at 2:15PM."

"AUGUST 12th??  Really, because I'm new?"

"Yeah, he's really popular and very busy... would like to book the appointment?"

"Um, but I have issues now that I need help with - not two month from now?"

"Would you like to book an appointment with his physicians assitant then?  But - She's not available until the first week of August?"

"Second grade work and I still need to wait?"

"Um...yeeeeaaaah, sorry.  It's policy."

So - my rant is this - why two months for new patients??  Why not just book the damn appointment like any other appointment - I have issues people!!!  Great, he's popular, but you scare off new patients when you tell them that "New patient appointments are in August?" 

Um hello - we're in JUNE!? WTH am I going to do with an AUGUST appointment??!!!

Did I book the appointment - yes - but I'm calling around to see if I can get someone else.  *sigh*


----------



## jeanarick (Jun 20, 2011)

Oh Dream, I know how you feel.  My husband is retired military so we're on Tricare, which is great because our premiums and co-pays are so low, but it's bad because it's so hard to find Doc's that accept Tricare.  When they do take Tricare quite often they are not accepting new Tricare patients.  It is so frustrating and forget about finding a specialist!  If I need care from a specialist I usually have to drive 1 - 2 hours from my home to find one that's "In Network".  I don't know what the answer is, we've been fighting it for 15 years.


----------



## magosienne (Jun 20, 2011)

I feel you, here whatever the specialist if you are a new patient, you have to wait too, and two months is not unusual. And it's just town doctors ! If i were to consult in a hospital for my eyes, it's a six months wait at best. The majority of specialists also require a letter from your generalist, otherwise you're not refunded as much.


----------



## janetgriselle (Jun 20, 2011)

> Originally Posted by *jeanarick* /img/forum/go_quote.gif
> 
> Oh Dream, I know how you feel.  My husband is retired military so we're on Tricare, which is great because our premiums and co-pays are so low, but it's bad because it's so hard to find Doc's that accept Tricare.  When they do take Tricare quite often they are not accepting new Tricare patients.  It is so frustrating and forget about finding a specialist!  If I need care from a specialist I usually have to drive 1 - 2 hours from my home to find one that's "In Network".  I don't know what the answer is, we've been fighting it for 15 years.


I know how that is. I can't stand Tricare. I've been dealing with an issue for over a year because physical therapy has been so inconsistent due to having to move to three different states in the past year. It's a nightmare. I guess I should be happy I have insurance at all, but it's just hard when I had better before I married my husband. I guess we'll have to wait until I get a better job


----------



## DreamWarrior (Jun 20, 2011)

All this scares me.  I pay for private insurance and even that sucks... I really do not want Obama to implement a country wide health care plan.

I hear horror stories about Tri-Care.  I feel for you Jeannie.


----------



## Dragonfly (Jun 20, 2011)

I hate to tell you but it is a lot worse in Canada -- Ontario anyways.

First off, I must see my family doctor. She will then determine if a referal to a specialist is warranted.

If it is, she makes the referral to whichever Specialist is taking new patients. I'll use a Dermatologist as the specialist.

Unless it is an emergency, I can expect to wait a minimum of 9 months to see a Dermatologist. My family doctor will treat me until I see the specialist.

I do want to state that if the family doctor does feel a referal is an emergency, I'll get to see the Specialist within a few day or even that day, depending on the situation.

The only good thing is that I don't pay for the appointments, bloodwork, x rays, scan, etc, etc.. And our prescriptions are a lot cheaper than what Americans pay.


----------



## jeanarick (Jun 20, 2011)

I've heard that about Canada's socialized medicine.  Whenever there's a debate going on and someone uses Canada's medical system as an idealized model, I always say, ask someone from Canda what they think about it before you assume it's so great.  I've heard horror stories of people waiting months for much needed surgeries.
 



> Originally Posted by *Dragonfly* /img/forum/go_quote.gif
> 
> I hate to tell you but it is a lot worse in Canada -- Ontario anyways.
> 
> ...


----------



## magosienne (Jun 20, 2011)

> Originally Posted by *DreamWarrior* /img/forum/go_quote.gif
> 
> All this scares me.  I pay for private insurance and even that sucks... I really do not want Obama to implement a country wide health care plan.
> 
> I hear horror stories about Tri-Care.  I feel for you Jeannie.



It's social justice, to have a basic health insurance. You also feel protected in a way. It all depends on what Obama includes in this, if it's very minimal then it's not a progress. Also the private insurances in my country cost an arm and a leg. But i will not say it's a perfect system either. In my country the system has determined a "price" for each thing, and it refunds for example 80% of that price. The rest is refund by your mutual company. But doctors, depending on their sector, may charge more than the price, and this part is not refund of course. It also depends if the specialist is free of choice, or if you need a referral. The referral system has been increased lately.

The meds deemed not so effective anymore are also not refund.

All in all the weight of the refund of your health costs relies on your mutual company.

The one thing that's good in France is all the non prescription meds, despite depending on the pharmacist for their price, remain of a relative low cost. Some even do promotions on ibuprofen or paracetamol tabs for example.


----------



## divadoll (Jun 20, 2011)

In BC, if I get a referral from my doctor, I don't have to pay for the treatment.  If I go directly to a dermatologist, I have to pay out of pocket for treatments.  I personally think that there are good things and bad things about Canadian Health Care.  I don't think its worst that US health care.  Since they took optometric care out of public health care, I have to pay $105 for an eye doctor appt.  There are optometrists charging $150 a visit too.  I've gotten used to free healthcare but that comes at a price of waiting.  Emergencies do get priority so I know I will get treatment when I NEED it.  I don't find dermatology appt's to be life threatening so I'll wait my turn.  




> Originally Posted by *Dragonfly* /img/forum/go_quote.gif
> 
> I hate to tell you but it is a lot worse in Canada -- Ontario anyways.
> 
> ...


----------



## Dragonfly (Jun 20, 2011)

It is true that if one requires elective surgery (meaning not an emergency), there can be months of waiting.

But if one needs emergency surgery, its only a matter of getting an OR, qualified medical staff, and surgical instruments and any vital medical equipment.

This typically constitutes a wait of a few hours, if not sooner.

Quite parallel to the US.

I agree with Divadoll - there is both good and bad to be said for Canada's health care system.

But one thing to be sure - no Canadian goes without proper healthcare, regardless of their economical status.

Sadly, many other countries cannot say the same about their citizens.


----------



## janetgriselle (Jun 20, 2011)

> Originally Posted by *DreamWarrior* /img/forum/go_quote.gif
> 
> All this scares me.  I pay for private insurance and even that sucks... I really do not want Obama to implement a country wide health care plan.
> 
> I hear horror stories about Tri-Care.  I feel for you Jeannie.



AMEN! I totally agree with you. Obama's plan will be worse than Tricare, more red tape and more problems.

Btw, it's taking me _two months _to get a dentist appointment here in Texas because I'm a new patient. Tricare is definitely not all it's cracked up to be. It drives me nuts when I have friends that rave about our "free army healthcare". Dental isn't free and medical is not fun to deal with at all.


----------



## divadoll (Jun 20, 2011)

I think Americans have to give a revised health care system a chance so that Every American can have healthcare.


----------



## DreamWarrior (Jul 5, 2011)

So - I went to my second choice derm appointment today.

He came in highly recommended and even does radio spots on the local stations.

I went to his office building and I was feeling optimistic - it was a modern office building in a trendy suburban area - then I realized his office was in the basement. 





Ohh kay... I go in and again, I'm disappointed to see ugly stained grey carpeting and mediocre dated decor.  The plus here is that he had a display case with creams and such that I assume are products he recommends.  There were informational brochures and a small 15" tube TV in the corner. 

Some of the office signs were posted with scotch tape and the glass had residue of old tape marks.



  I used their bathroom which was a huge mistake.  It had a urinal and toilet and a small sink with dated tiles and stained grout.  The sink was archaic and was scratched and stained with old rusted and crusted faucets.  At this point I was ready to walk out and never return.  Why I actually didn't, I don't know.  Something in my head said to give the doc a try - there is SOME reason he is top rated?! Right!!??

Good news - One word describes the doc.  Sweetheart.  He was an slim man in his 50's with a great complexion and goatee (did I mention I love goatee's?).  He listened to me and ALL my concerns... not just one.  He didn't say - well, lets focus on one and we'll deal with the rest later.  He also didn't interrupt me, he let me finish my sentence and asked his questions... he explained the technical terms of my concerns and understood why, at my age, the acne is a concern.

He told me why were not going with antibiotics and why we were not going to try topical treatments... he prescribed a diuretic. 



Yes, a diuretic.  Has anyone ever tried this method?

Different, that's for sure.  I've never heard of it being used for acne treatments - but there's something there with testosterone therapy, etc. etc. and its a small dosage so that it wouldn't cause any serious side effects.  No change in my diets and no risks to the rest of my system. 

I will start this treatment tonight and I go back in six weeks to see where we stand.  I can apply makeup and continue my regimen as I normally would. 

So, I think I'm going to change my career and become an interior designer/consultant for doctors!!!  I almost walked on this guy because of the way his office/bathroom looked.  Don't they know that there are people like me who are skeeved out by appearances like this? 

Don't get me wrong, I'm NOT rich and snooty - but if I go to my doctors office (especially a derms office), I hope it to look modern and clean - not stained and dated.  My house isn't a mansion, but you bet you can come over any day and use my bathroom without feeling you need a shot of antibiotics after you leave.


----------



## jeanarick (Jul 5, 2011)

I think cleanliness and appearance of a Doc's office is extremely important!!  It doesn't say much for him or his staff for his office to be in that condition.  I don't think there is anything wrong with you bringing this to his attention.  I bet he rarely steps foot in his front office or front bathroom and isn't aware of how it is perceived by his patients.


----------



## DreamWarrior (Jul 5, 2011)

I think you're right Jean - I cant imagine the employees using the restroom or even giving one rats @ss about what the waiting room looks like.  I think I'll mention it at my next appointment.


----------



## Dragonfly (Jul 5, 2011)

I hadn't heard of treating acne with a diurectic. I found this while gooling:

*Spironolactone* a potassium-sparing diuretics (water-pill) is also used in the treatment of acne. It helps decrease the effects of the hormone responsible for oil production.

*How to treat acne with spironolactone *

No matter you are male or female, no matter that you are a teenager or a grown up, acne is one of the worse nightmares. Acne is caused by a bacteria found on the skin of 90% of the people (but fortunately a much smaller percentage will develop acne).

  
*Hormonal changes *

There are many treatments against acne: oral and topical antibiotics or benzoyl peroxide products. But recently the specialists agreed on treating not the bacteria itself, but the organism's response to it, specially if there are hormonal factors influencing the acne. In this case, other things like birth control pills or spironolactone may also be needed.

Spironolactone, named also Aldactone or for short Spiro, is an antiandrogen (blocks the male hormone) and has great effect not only in treating acne, but on hair, skin, scalp and body hair (decreases the hair's growth - hirsuitism) too. Spironolactone is also an antihypertensive, so will not affect a normal blood pressure.

*When taking spironolactone you should: *


drink plenty of water in order to avoid dehydration (it is a water pill-diuretic)

eat something (or drink milk) to avoid stomach upset

avoid salt, salt substitutes or other products that contains potassium, otherwise the level of the potassium in your blood will be too high and will have as results: heartbeat irregularities, leg cramps, thirst, weakness, headaches

talk also to your gynecologist because your periods may become irregular (in case you don't take already oral contraceptives)

avoid by all means to get pregnant because the baby may have birth defects

be evaluated by the doctor every two, three months (the positive effects can be better observed and the side effects can be diminished).

*There are also some spironolactone side effects that should be taken in consideration: *


menstrual irregularity (specially if you don't take birth control pills)

breast tenderness

increase fertility (because enhances estrogen and inhibits testosterone), but the baby may have birth defects so a good contraception is needed

increase urination (because it is a mild diuretic)

may appear a mild stomach upset.

You can see spironolactone benefits against acne after a period of two to four months and the needed dosage per day is from 25 to 150 mg. You may take spironolactone a year or two, but every couple of months the doctor should check o your progresses.

If you are pregnant or if you have some problems with your kidneys it is better not to take spironolactone. Otherwise, but only under doctor's observation, you may use it to solve you acne problem.

http://www.howtoall.com/Healthfiles/howtotreatacnewithspironolactone.htm


----------



## DreamWarrior (Jul 11, 2011)

This is exactly what was prescribed to me.

Its been a week and I have zero changes, if anything, I feel that my breakouts have gotten worse. 

My acne size  has reduced, so their not as large, but they HURT and are tender to the touch.  The one's that have dried out left extremely large scars/scab like marks on my face.  My mother says it looks like someone took a cigarette to my face.

I havent had acne this bad ever... to the point that people are commenting regularly and are concerned.  I dont know if hormones played a part in this since nothing drastic has changed in the past year.  My diet went south for a while, but other than that - I've lead a pretty regular life.  *sigh*  two months huh?


----------



## MakeupofDesire (Jul 11, 2011)

I live in Montana and we are experiencing the same problems with getting in to see docs.  I just made a new patient appt and it was 3 months out!  I had my primary care doctor call their office and now my appt is next month.  So, not a fun way to spend your time, hunting down doctors to get you in with another!  I've been disabled for 6-7yrs now and I'm only 32.  So I know all about doctors and how hard appts can be to get, and how to get snuck into spots sooner by basically brown-nosing the nurse.  The nurses are our friends!  They can get you into spots that "don't exist".  They are also the ones that give shots, so make them your friend!  /emoticons/[email protected] 2x" width="20" height="20" />  It really makes a huge difference!  I've been lucky to be on 2 insurances to cover all my doctor and hospital stays.  I've been in and out of the hospital my whole life and know that my mom even dealt with all the bs back when I was younger, too.  Right now I have to make my monthly appts all at one time in order to be able to see my doctor when he/she wants to see me.  They are booked up so fast and for so long, new pt or not!

I've been on *Spironolactone* for over 10 yrs for a medical condition I have.  I didn't know it was a tx for acne.  I also just had my dose doubled due to extreme edema (swelling) mostly on my legs, ankles, and feet, but I'm swollen and retaining fluids all over my body, due to right sided heart failure, which I have.  So my ankles can't even be found and I'm pitting (when you poke the swollen area it stays dimpled) like crazy.  I've never had bad acne, just very mild.  Now I'm wondering if over the past 10+ yrs that I've been on *Spironolactone*, maybe it was helping my skin, too?  Doesn't much matter b/c I'm getting older and less oily, so less break outs.  That and I use my Clarisonic weekly if not more often.


----------



## DreamWarrior (Aug 17, 2011)

So...

I finally have that appointment tomorrow. 



  I'll let you know how this dermatologist is and what he recommends.

Although, I'm really starting to rethink my makeup.  I'm on my 20th no makeup week and I have fewer breakouts... I could be that the diuretic finally kicked in and is working...  IDK.


----------



## jeanarick (Aug 17, 2011)

Could be the medicine, could be the makeup...hard to tell since you started/stopped at the same time.  Hope this doc gives you some clear answers.


----------

